Maine gets moving on an aging approach beyond nursing homes

August 25, 2014 10:56 amUpdated: August 25, 2014 10:57 am

Troy R. Bennett | BDN

Troy R. Bennett | BDN

Lee Picker (right), 75, smiles after speaking at a Wednesday news conference in Brunswick, where Maine House Speaker Mark Eves announced a series of proposals designed to build more affordable housing for seniors and otherwise help them remain in their homes as they age.

Unsurprisingly, there’s an overwhelming desire among Maine’s older adults to remain home and independent as long as possible. But that can be a challenge in the state, where the quality of some of the oldest homes in the nation make that option dangerous, the remote locations in which many older adults live make it unrealistic, and low incomes make it unaffordable for many.

As Maine, already the oldest state in the nation, becomes older, the state is in need of some serious planning, policy shifts and bold action — both at the statewide and community levels — to make it possible for older adults to remain at home and connected to their communities for as long as possible.

House Speaker Mark Eves, D-North Berwick, deserves credit for taking on this major issue, bringing a range of players to the table and starting to focus legislative attention on an aging strategy that goes beyond simply ensuring sufficient funding for nursing homes and assisted living.

Eves on Wednesday unveiled the first three policy initiatives from this work, with more to come, he said. A $65 million bond would partially fund the development of 1,000 affordable senior housing units across the state in locations close to health care services and other amenities. A higher property tax credit for seniors would make it more affordable for those with low and moderate incomes to remain home. And higher Medicaid reimbursement rates for direct care workers, who deliver in-home health care services for seniors, would allow higher wages for those workers, ideally reducing turnover among the direct care workforce.

Eves hasn’t identified a funding source for the latter two initiatives, though he says legislators can find the funding if they agree that they are priorities. Still, Eves has identified three policy areas to tackle that address proven needs.

There’s no formal assessment yet showing the exact need for new senior housing units across the state, but when developers have built new senior units in recent years, the developments have filled up quickly and attracted waiting lists, said Greg Payne, coordinator of the Maine Affordable Housing Coalition. At this point, Payne said, the funds from a $36 million affordable housing bond passed by the Legislature in 2009 have been nearly exhausted, leaving few resources to develop affordable senior units.

Even without investing new resources, there’s more Maine could do at the state level to ensure the money the state already spends on long-term care for older adults is spent wisely. As part of Eves’ push on aging issues, he and other lawmakers could explore crafting a global budget for long-term care — as a number of states have. Rather than reserve separate line items for nursing homes, in-home care and assisted living, for example, a global budget would combine funding for all long-term care services, making it easier for the state to shift spending based on what each senior needs and the most efficient use of resources. The result could be an incentive for the state to invest in less expensive at-home care and fewer budget battles over protecting existing pieces of the budget pie.

It also is important to recognize a full aging strategy that allows seniors to stay independent and connected to their communities won’t come from the Legislature. Individual communities across Maine are already taking action.

On the Blue Hill Peninsula, volunteers for At Home Downeast give dozens of senior members rides to medical appointments and the grocery store, while nurses on staff visit members at home to make sure they’re taking their medications. Members pay on a sliding scale, based on what they can afford. In the Portland area, volunteer drivers for ITN Portland offer those same services. As they volunteer their time, they earn credits they can redeem when they are older and unable to drive.

Keeping the state’s aging population independent and in their communities presents a complicated public policy challenge. Fortunately, Eves has shown political will to take it on, and Gov. Paul LePage has shown some tacit support for his efforts.